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Article
MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XVI: HARMS LINKED TO DRUGS ADMINISTERED DURING ANESTHESIA

Authors: Salam N Asfar --- Jasim M Salman
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2019 Volume: 25 Issue: 1 Pages: 74-75
Publisher: Basrah University جامعة البصرة

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Abstract

MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XVI: HARMS LINKED TO DRUGS ADMINISTERED DURING ANESTHESIASalam N Asfar@ & Jasim M Salman# @MB,ChB, MSc, Professor of Anesthesiology, College of Medicine, University of Basrah. #MB,ChB, DA, FICMS, Assist. Prof. & Consultant Anesthesiologist, College of Medicine, University of Basrah, Basrah, IRAQ. Unpleasant drug incidents are common during medical action. In anesthetic practice, the probability of errors is greater because of more tension and rapidity. Morbidity and even mortality are more expected in the course of anesthesia. Apart from many hazards that patients are exposed to such as; Biological hazards, Mechanical hazards, Chemical hazards, Physical hazards, and Personal Hazards1, it seems that danger of drug problems are more.

Keywords

crises --- anesthesia


Article
Single Buccal Injection for Anesthesia of Upper First Molar

Authors: Mohamed S. Suleiman --- Wafaa K. Fathi --- Rayan S. Hamid
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2008 Volume: 8 Issue: 11 Pages: 56-60
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: A clinical trial was carried out to assess the efficiency of a single buccal injection to achieve
anesthesia of the buccal aspect of the upper first molar instead of the traditional two injections. Materials
and Methods: The subjects included in the clinical assessment were those needing extraction of
an upper first molar of either side. For the purpose of comparison, the sample was randomly divided
into two main groups: Group I (control group) which included 100 subjects who were to receive two
buccal injections and a single palatal injection before extraction. While Group II (trial group) included
100 subjects who were to receive a single buccal injection and a single palatal injection before extraction.
The following data were recorded: Pain on needle insertion, pain on deposition of solution, onset
of surgical anesthesia and adequate surgical anesthesia. Results: The first criterion recorded was pain
on needle insertion where the results showed no significant difference between both groups. The
second criterion was pain on deposition of solution. Here the results also showed no significant difference
between both groups in this aspect. For onset of surgical anesthesia, no significant difference was
shown between both groups. In regard to pain grade experienced during surgery for both groups, the
results showed that grade A anesthesia was recorded in 95% of patients in group I , whereas in 93% of
patients in group II. Grade B anesthesia was recorded in 5% of patients in group I and in 7% of patients
in group II. Statistically speaking, no significant difference was disclosed in regard to pain assessed
during the extraction of the tooth between both groups. Conclusions: The achievement of successful
local anesthesia is a continual challenge in dentistry. Any suggested new approach for achieving adequate
anesthesia for either the maxilla or mandible as long as it is safe and effective can be recommended
for routine dental care.


Article
A clinical evaluation on the alkalization of local anesthetic solution in periapical surgery

Authors: Fa’iz A Al–Sultan --- Wafaa Kh Fathie --- Rayan S Hamid
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2006 Volume: 6 Issue: 7 Pages: 71-77
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: To assess the effect of alkalization of local anesthetic solution for the purpose of enhancing itsefficiency in periapical surgery. Materials and Methods: A total sample of 80 patients, all needingperiapical surgery on one or more of their upper anterior tooth (teeth) was subjected to this trial. For thepurpose of comparison, the sample was randomly divided into two groups based on the local anestheticsolution that they were to receive before surgery. The first group(control) included those patients whoreceived the commercially available local anesthetic solution with a standard pH of 3.5.The secondgroup (trial group) included those patients who received a pH adjusted local anesthetic solution at 7.2(using sodium bicarbonate).Prior to, and at the completion of intended surgery, the following datawere recorded: Pain during injection, onset of achievement of surgical anesthesia, pain duringoperation and the duration of operation itself. Results: A significant difference in regard to onset ofachievement of surgical anesthesia between both groups was noticed with a faster onset in group two where the patients received a pH adjusted local anesthetic solution when compared to control group where the patients received the commercially available local anesthetic solution. Also, less pain on deposition of solution was noticed in the second group as well as less pain score levels were recorded during operation in regard to the same group. Conclusion: The pH adjusted local anesthetic solutionsmay provide certain advantages when compared to the commercially available local anesthetic solutions regarding enhancement of anesthetic efficiency, reduced pain on injection as well as during surgery.


Article
ANESTHESIA USING LARYNGEAL MASK AIRWAY FOR INTRA-NASAL SURGERY; A COMPARATIVE STUDY

Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 43-49
Publisher: Basrah University جامعة البصرة

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Abstract

The purpose of the study was to compare the suitability and safety of the laryngeal mask airway (LMA), for intranasal surgery (INS) anesthesia, with endotracheal tube (ET) anesthesia.we studied 65 patients (ASA grade I and II, according to American Society of Anesthesia classification), aged (18-39) years. The study population was scheduled for elective intranasal surgery. The patients were randomly assigned into two groups: the first group (33 patients), a laryngeal mask airway (LMA Group) was inserted under propofol , fentanyl and muscle relaxant (atracrium), anesthesia was maintained by using a mixture of halothane in N2O/O2. The second Group (32 patients), an endotracheal tube (ET Group) was inserted under propofol, fentanyl and muscle relaxant (atracrium), anesthesia was maintained with a mixture of halothane in N2O/O2.All complications concerning airway insertion, removal or interruption of surgery for compromised airway and ventilation were recorded. Mean blood pressure, heart rate and pulse oxymetry, were continuously monitored and recorded before and after induction and airway device insertion, followed by 10 minutes intervals. Data were analyzed using chi square statistical test; Null hypothesis was rejected at P> 0.05.In LMA Group, there were no episodes of post removal laryngospasm. The incidence of oxyhemoglobine desaturation at removal was significantly reduced compared with that in ET Group (P< O.O2). The number of patients with oxyhemoglobine desaturation less than 92% on airway device removal was 0% in LMA Group, 3 patients (9.375%) in ET Group.In ET Group, the mean blood pressure and heart rate showed significant variation between the different time measurements (P> 0.005). Intubation and extubation resulted in significant transient increase in mean blood pressure and heart rate. In LMA Group, the mean blood pressure was less than baseline value from 1 minute after induction onwards (P< 0.005) and did not show any significant changes during the different time points measurements. LMA application or removal did not cause any significant increase in mean blood pressure or heart rate (P< 0.001).We conclude that using LMA is suitable method for intranasal surgery. It provides a safe, protected airway with a smoother emergence from anesthesia than tracheal intubations. Anesthesia using LMA for intranasal surgery provides a stable circulation.


Article
A clinical comparison between maxillary and mandibular posterior teeth using local anesthesia and normal saline by the periodontal ligament injection (An in vivo study)

Authors: Majidah K.W. AL-Hashimi ماجدة الهاشمي --- Raad S. Al-Doori رعد الدوري
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: special issue 1 Pages: 18-23
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Local anesthesia is the primary method used in dentistry to control patients’ pain. However, even in thepresence of adequate soft tissue anesthesia, there may be incomplete pulpal anesthesia. This is particularly true inthe mandible where obtaining profound pulpal anesthesia may be difficult. The periodontal ligament injection hasreceived much attention in the dental literatures. lntraligamentary anesthesia has been advocated as a primary anda supplemental injection technique. The purpose of this study is to evaluate, with electrical pulp tester, the anestheticefficacy of the periodontal ligament injection using 2% Lidocaine with 1:80000 epinephrine and normal saline in fortyvolunteers. The success rate was defined as no patient’s response to the maximum output of an electrical pulptester. Also pain rating during initial needle penetration and injection of solution were compared.Material and method: Forty adult volunteers participated in this study. The subjects were divided into four groups (10subjects each): Group Ia: each subject received a periodontal ligament injection in mandibular first premolar andfirst molar right or left side with Lidocaine injection and pulp tested each minute by EPT and Ethyl chloride. Group 1b:each subject received a periodontal ligament injection in mandibular first premolar and first molar right or left sidewith normal saline injection and pulp tested each minute by EPT and Ethyl chloride. Group IIa: each subject receiveda periodontal ligament injection in maxillary first premolar and first molar right or left side with Lidocaine injection andpulp tested each minute by EPT and Ethyl chloride. Group IIb: each subject received a periodontal ligamentinjection in maxillary first premolar and first molar right or left side with normal saline injection and pulp tested eachminute by EPT and Ethyl chloride.Results: The results showed that the duration of profound pulpal anesthesia, using 2% Lidocaine with 1:80000epinephrine, was 10 minutes and injection of anesthetic solution and normal saline in clinically healthy teeth wereonly mildly discomforting. The periodontal ligament injection using normal saline was not effective in producinganesthesia. A conclusion was drawn from the study that the periodontal ligament injection can be used effectively,as a primary injection technique, to anesthetize mandibular posterior teeth especially the first molars

Keywords

Pain --- PDL --- local anesthesia


Article
MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XIII: REGIONAL ANESTHESIA

Authors: Salam N Asfar --- Jasim M Salman
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2017 Volume: 23 Issue: 2 Pages: 74-75
Publisher: Basrah University جامعة البصرة

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Abstract

MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XIII: REGIONAL ANESTHESIA Salam N Asfar@ & Jasim M Salman# @MB, ChB, MSc, Professor of Anesthesiology, College of Medicine, University of Basrah. #MB,ChB, DA, FICMS, Assist. Prof. & Consultant Anesthesiologist, College of Medicine, University of Basrah, IRAQ.Regional anesthesia is broadly utilized and has been considered to pose few risks once the block is set up. However, dangerous issues can happen both during the establishment and maintenance periods of a regional block which require prompt recognition and management. The risks includes; local anesthetic toxicity1,2, misdirected or misplaced needles and cannulae, and a variety of other problems both amid and after blockade can lead to morbidity or mortality3–5. Some of these may be obscure and not related to the regional anesthetic method itself.


Article
MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XV: SEPSIS

Authors: Salam N Asfar --- Jasim M Salman
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2018 Volume: 24 Issue: 2 Pages: 86-87
Publisher: Basrah University جامعة البصرة

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Abstract

Sepsis which is defined as systemic response to infection may potentially causes multiple structures physiological stress and dysfunction such as; respiratory, renal, cardiovascular, and hematological. Because quick consideration should be paid to so many body systems, prepared approach during anesthesia for a septic patient is a must1. Patients with sepsis show signs of systemic inflammatory response syndrome, as result from generalized reaction to inflammation which may be caused by a wide range of infectious and non-infectious causes for example, burns, pancreatitis and multiple trauma2.

Keywords

sepsis --- crises --- anesthesia


Article
A Comparative Clinical Evaluation on Three Maxillary Nerve Block Techniques of Local Anesthesia in Minor Oral Surgery

Author: Rayan S Hamid
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2013 Volume: 13 Issue: 21 Pages: 52-57
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: To compare three maxillary nerve block techniques of local anesthesia in terms of success dur-ing minor oral surgical procedures on maxillary teeth. Materials and Methods: The clinical trial was conducted at the Department of Oral and Maxillofacial Surgery/ College of Dentistry/ Mosul Universi-ty. The subjects enrolled in the trial required surgical procedures on their upper anterior and / posterior teeth. The sample included 60 subjects who were divided into three groups of 20 each; Group I (control I) patients who were to receive the posterior superior alveolar nerve block technique. Group II (control II) patients who were to receive the infraorbital nerve block technique and Group III (control III) pa-tients who were to receive the maxillary nerve block technique of local anesthesia. For comparison, the following variables were recorded for the three techniques: Positive aspiration, onset of adequate surgi-cal anesthesia and pain grade scale during surgical procedure. Results: In regard to positive aspiration before injection of solution, the results showed no significant difference regarding positive aspiration among the three techniques. For onset of adequate surgical anesthesia, the results disclosed no signifi-cance difference in mean duration of onset of anesthesia among the three groups. In regard to pain ex-perienced during the surgical procedure , no significant difference was recorded among the three groups. Conclusions: The maxillary nerve block technique via the high tuberosity approach seems to be a safe and effective technique for achieving anesthesia of the hemimaxilla as long as there is strict adherence to the anatomical landmarks and approach described. The technique carries with it a high success rate and with specific applications can allow the dentist to provide painless dental treatment


Article
A pilot double blinded clinical trial to compare between Tramadol HCL and Lidocaine HCL as local anaesthesia amongst hospital-outpatient adult dental attendees Mosul-Iraq

Authors: Tahani A. Alsandook --- Yahya A. Al-Haideri
Journal: Journal of Oral and Dental Research مجلة طب الفم والاسنان ISSN: 23106417 Year: 2013 Volume: 1 Issue: 1 Pages: 13-16
Publisher: Iraqi Association for Oral Research الجمعية العراقية لبحوث طب الفم

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Abstract

Aim of the study: The aim of the current study is to compare the local anesthetic action of tramadol HCL (with adrenaline) and lidocaine HCL (withadrenaline) in minor oral surgery.Method: A double blind study including 124 patients, requiring minor oral surgery (conventional tooth extraction, surgical removal of impactedteeth and periapical surgery) in the lower molar teeth, allocated randomly into two groups:Group A (n=62), in which each patient received initial dose of one dental cartridge, 1.8ml, from drug A (36mg of Lidocaine HCL with (0.0225mg)adrenalin), for conventional tooth extraction, doubled in case of surgical removal of impacted tooth and periapical surgery.Group B (n=62) received one dental cartridge, 1.8ml, from drug B (50 mg of tramadol HCL and (0.0225mg) adrenalin diluted to 1.8 ml by distilledwater), again this dose was doubled in case of surgical removal of impacted tooth and periapical surgery.For each patient the onset of anesthesia, number of cartridges used, duration of surgery and the degree of pain (with a 10-cm visual analog scaleVAS), had been recorded during the operation.Postoperatively, the patients were instructed to record exactly when the parasthesia disappear and anyadverse effects such as nausea andor vomiting on the first day of operation.Result: there was no significant difference between the two study groups in the number of cartridges (1.33/±0.510, 1.37/± 0.519)nor the onset ofanesthesia(2.95/±1.46, 3.14/±1.31) minutes, intraoperative pain (0.1935/±0.697, 0.2096/±0.656), duration of surgery (12.77/±10.51, 14.11/±11.66)minutes, and side effects. However there was a significant difference in duration of anesthesia(153.14/±35.10, 117.11/±26.88) minutes, where thegroup A achieved longer duration of action of local anesthesia.Conclusion: These study findings suggested that Tramadol HCL can be used as alternative to Lidocaine HCL in combination with adrenaline toachieve local anesthesia in situation where Lidocaine HCL is contraindicated or when adequate local anesthesia with minimal paraesthesia isrequired. Validation and replication of these study findings should be considered in future research.


Article
Infiltrative Technique in Post-Tonsillectomy Pain Reduction with 0.5% Bupivacaine & 1/200000 Adrenaline
طريقةارتشاح البيوبيفاكين 0.5% مع الادرينالين 1/200000 في تقليل الالم الناتج من عملية استئصال اللوزتين

Author: Nasir U. Hassen د. ناصراسامة حسن
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2010 Volume: 23 Issue: 3 Pages: 204-207
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background Tonsillectomy is one of the commonly performed surgical procedures in otolaryngology. Postoperative morbidity, including pain, bleeding, inadequate oral intake and dehydration can create problems. Pain after tonsillectomy still remains to be a frequent problem. In an effort to reduce post-tonsillectomy morbidity, numerous modifications and adjuncts to standard surgical technique have been proposed. Objective: To determine the effectiveness of 0.5% bupivacaine and 1/200000 adrenaline in post tonsillectomy pain using an intra-individual design.Methods: 47 patients aged 8-35 years were included in a prospective study, diagnosed clinically as chronic tonsillitis in Karama teaching hospital. Patients received a local infiltration of 0.5% bupivacaine and 1/200000 adrenaline solution on the right tonsillar bed, and received a local infiltration of normal saline on the left tonsillar bed as control, at the end of the operation in the theatre. Postoperative pain was assessed with a visual analog scale at 4,6,8,12,24 hours after the procedure.Result: According to visual analog scale results, the severity of pain was less in the site infiltrated with 0.5 bupivacaine and 1/200000 adrenaline than the site infiltrated the normal saline.Conclusion: local 0.5% bupivacaine and 1/200000 adrenaline infiltration in tonsillar bed can reduce post tonsillectomy pain.Key ward: Bupivacaine, Tonsillectomy Pain, Local anesthesia.

خلفية البحث:تعتبر عملية استئصال اللوزتين من اكثر العمليات التي تجرى في قسم الانف والاذن والحنجرة.ان العواقب ما بعد العملية هي : الالم , النزف , صعوبة تناول السوائل عن طريق الفم و فقدان سوائل الجسم.هناك جهد كبير من اجل تقليل عواقب الالم ما بعد العملية وتحويرات كثيرة في عمليات استئصال اللوزتين.الهدف:تحديد فعالية البيوبيفاكين 0.5% مع الادرينالين 1/ 200000 في التاثير على الالم ما بعد استئصال اللوزتين.الطريقة:اجري البحث على 47 مريضا, اعمارهم ما بين (8-35) سنة , دراسة تطلعية في مستشفى الكرامة التعليمي على مرضى يعانون من التهاب اللوزتين المزمن و تم علاجهم بعملية استئصال اللوزتين, تم اعطائهم البيوبيفاكين 0.5% مع الادرينالين 1/ 200000 في الجهة اليمنى من موقع اللوزتين , والمحلول المتعادل الملوحة في الجهة اليسرى من موقع اللوزتين عند نهاية العملية. تم تقييم الالم بعد العملية بواسطة مقياس التدرج المماثل البصري في24,12,8,6,4 ساعة.النتائج:استنادا الى نتائج مقياس التدرج المماثل البصري شدة الالم كان اقل في جهة الارتشاح بالبيوبيفاكين 0.5% مع الادرينالين 1/ 200000 عن الجهة التي تم وضع المحلول المتعادل الملوحة.الاستنتاجات:الزرق الموضعي بالبيوبيفاكين 0.5% مع الادرينالين 1/ 200000 بواسطة الارتشاح في موضع اللوزتين يقلل الالم بعد العملية.

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